PHD IS ENDEMIC IRAQ. CXR IS THE CHIEF DIAGNOSTIC MODALITY. CONSIDER DIFFERENTIAL DIAGNOSES. PREVENTION IS ACHIEVABLE.SURGERY IS STILL THE MAIN TREATMENT.ALWAYS TRY TO PRESERVE LUNG TISSUE. LUNG RESECTION IS DONE SPORADICALLY FOR CERTAIN INDICATIONS. SEARCH FOR CNS AND PA CYSTS IN PATIENTS WITH DISSEMINATED HYDATIDOSIS.

1. https://sulaimaniu.academia.edu/AbdulsalamTaha

2. PHC
• LIFE CYCLE.
• CYST STRUCTURE.
• PLAIN CXR AND CT SCAN.
• BRONCHOSCOPY.
• PRINCIPLES OF SURGERY.
• SELECTIVE CASES.

3. LIFE CYCLE

5. STRUCTURE OF CYST

6. LAMINATED MEMBRANE

7. PLAIN CXR

8. PLAIN CXR: THE INTACT CYST

9. CXR: BILATERAL CYSTS

10. CT SCAN: INTACT CYST

11. CT SCAN: MULTIPLE INTACT CYSTS

12. PERIVESICULAR PNEUMOCYST

13. THE WATER-LILY SIGN

14. CAVITARORY LESION

15. CT SCAN: INTRA-BRONCHIAL RUPTURE

16. CT SCAN: THE CENTRAL CYST

17. ATYPICAL RADIOLOGICAL DENSITIES

18. ATYPICAL RADIOLOGRAPHIC DENSITY

19. ELEVATED DIAPHRAGM

20. THE INTRA-PLEURAL RUPTURE

21. PULMONARY ANGIOGRAPHY

22. RADIOGRAPHIC SIMULATORS
LOCALIZED BENIGN MESOTHELIOMA

23. LOCALIZED
MALIGNANT
MESOTHELIOMA

24. NEUROFIBROMA

25. NEUROBLASTOMA

26. FIBEROPTIC BRONCHOSCOPY

27. PRINCIPLES OF SURGERY
• Removal of cyst contents.
• Avoidance of soiling of operative field.
• Preservation of as much lung tissue as
possible.
• Closure of bronchiolar fistulae.
• Management of residual cystic cavity.
• Achievement of early and complete lung
expansion.

28. ANESTHETIC TECHNIQUES
• SINGLE OR DOUBLE LUMEN ET TUBES?
• FREQUENT SUCTION VIA ET TUBE.
• PROTECTION AGAINST ANAPHYLAXIS.
• SYNCHRONIZED INFLATION AND
DEFLATION OF THE LUNG WITH
SURGICAL PROCEDURE.

29. REMOVAL OF CYST
• ENUCLEATION.
• INJECTION, ASPIRATION AND
EVACUATION.
• ASPIRATION AND EVACUATION.
• EXCISION OF CYST.

30. ENUCLEATION OF CYST

31. INJECTION, ASPIRATION &
EVACUATION

32. ASPIRATION AND EVACUATION

33. SCOLICIDAL AGENTS
• POVIDONE IODINE.
• 10% HYPERTONIC SALINE.
• HYPERTONIC GLUCOSE.
• 10% FORMALDEHYDE.
• NONE IS AN IDEAL SCOLISIDAL AGENT.
• THE BEST IS ( CONTROLLED EVACUATION OF
CYST CONTENTS).

34. WHEN TO RESECT?
• HUGE SIMPLE HC CAUSING LOBE
DESTRUCTION.
• SEVERELY SUPPURATED RUPTURED CYST.
• MULTIPLE DAUGHTER CYSTS IN MOTHER CYST.
• LIFE-THREATENING HEMOPTYSIS.
• BROCHO-BILIARY FISTULA.
• HYDATID BRONCHIECTASIS.

35. HUGE INTACT PHC IN LUL IN AN 8 YR OLD BOY
MANAGED BY LOBECTOMY

39. CXR

40. CT SCAN

41. R THORACOTOMY

42. R THORACOTOMY

43. THE OPERATION

44. POSTOP CXR

45. MORBIDITY
• PROLONGED AIR LEAK.
• EMPYAEMA.
• PNEUMONIA DUE TO ASPIRATION OF CYTIC
CONTENTS OR WASHING SOLUTIONS.
MORTALITY
* UNRECOGNIZED CNS OR PULMONARY
ARTERY CYSTS.

46. TAKE HOME MESSAGES
• PHD IS ENDEMIC IN OUR
COUNTRY.
• CXR IS THE CHIEF
DIAGNOSTIC MODALITY.
• CONSIDER DIFFERENTIAL
DIAGNOSES.
• PREVENTION IS
ACHIEVABLE.
• SURGERY IS STILL THE
MAIN TREATMENT.
• ALWAYS TRY TO PRESERVE
LUNG TISSUE.
• LUNG RESECTION IS
DONE SPORADICALLY FOR
CERTAIN INDICATIONS.
• SEARCH FOR CNS AND PA
CYSTS IN PATIENTS WITH
DISSEMINATED
HYDATIDOSIS.

47. THANK YOU FOR YOUR ATTENTION!